Accounts Receivable Specialist Jobs

About The Position

Requirements

• High school diploma or GED.
• At least two years of healthcare insurance accounts receivable follow-up experience, working with or for a hospital or hospital system and directly with government or commercial insurance payers.
• Experience identifying billing errors and resubmitting claims, and following up on payment errors, low reimbursement, and denials.
• Experience reviewing EOB and UB-04 forms to conduct accounts receivable activities.
• Knowledge of accounts receivable practices, medical business office procedures, coordination of benefit rules, denial overturns, and third-party payer billing and reimbursement procedures and practices.
• At least two years of experience with accounts receivable software.
• Experience navigating payer sites for appeals or reconsiderations, benefits verification, and online claims follow-up.
• Ability to navigate Internet Explorer and Microsoft Office, including entering and sorting data in Microsoft Excel and using company email and calendar tools.
• Demonstrated ability to work both independently and in a team environment.
• Demonstrated experience communicating effectively with payers, understanding complex information, and accurately documenting encounters.
• Ability to work effectively with cross-functional teams to achieve goals.
• Demonstrated ability to meet performance objectives.

Responsibilities

• Verify or obtain patient eligibility and authorization for healthcare services through payer websites, client eligibility systems, or calls with insurers or healthcare providers.
• Update patient demographics and insurance information in appropriate systems.
• Research and appropriately status unpaid or denied claims.
• Monitor claims for missing information, authorization, and control numbers (ICN/DCN).
• Research EOBs for payments or adjustments to resolve claims.
• Contact payers by phone or written correspondence to secure claim payment.
• Access client systems for payment, open-claim, and other information needed to resolve claims.
• Follow guidelines for prioritization, timely filing deadlines, and system notation protocols.
• Secure medical documentation requested or required by third-party insurance carriers.
• Research provider billing manuals to obtain billing guidelines and requirements.
• Write technical appeal letters.
• Verify the accuracy of underpayments by researching contracts and claims data.
• Prepare claims for clinical audit processing when denials involve authorization, coding, level of care, or length of stay.
• Support Savista’s Compliance Program by following applicable policies and procedures, completing required training, reporting compliance concerns or incidents, handling patient information in a HIPAA-compliant manner, and maintaining confidentiality.